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RadioMD Presents: Healthy Children | Original Air Date: May 13, 2015
Host: Melanie Cole, MS
Guest: Mark R. Corkins, MD

Hear it from the doctor, with expert guest from the American Academy of Pediatrics. It’s Healthy Children, now our favorite mom, Melanie Cole, MS.

MELANIE: Do you have a picky eater? How can you get your child to eat a wide variety of food? Because you’ve heard and you know that this will make them healthier in the long run and give them a bigger opportunity to enjoy all the pleasures that food offers. My guest today is Dr. Mark Corkins. He’s the Division Chief of Pediatric Gastroenterology at the University of Tennessee Health Science Center.

Welcome to the show.

Dr. Corkins, tell us about picky eaters. If you had a picky eater, when you work with parents that have picky eaters, what’s the first, best piece of advice you give them?

DR MARK: Well, I will tell you I have four children and I had a picky eater. Now, this is going to sound like a funny thing to say, but the first and most important advice is, if you want your children to eat vegetables, you have to eat vegetables.

MELANIE: Absolutely.

DR MARK: The modeling is number one. I can tell you for a fact that I have seen it. Patient in clinic, mom says, “How do I get my child to eat vegetables?” I look at the mom and say, “What’s your favorite vegetable?” She says, “Well, I really don’t have one.” Then I said, “Then I kind of got a clue. Do you eat vegetables?” She says, “No, I don’t like vegetables. I don’t eat them.” Well, if you don’t eat them, the odds you’re going to get your child to eat them is pretty abysmal.

MELANIE: I hear that same thing all the time and I look at the parent and I say, “You won’t eat a salad or you won’t eat broccoli, or you don’t like asparagus or beets, but you want to try and get your children to like them and that’s almost an impossibility. You have to role model. You have to be that person. I myself, Dr. Corkins, am a cook. My kids garden with me, grow the vegetables, cook, we do it all together. I’m lucky because my kids will eat everything from chicken feet to whatever. But for the other parents out there, role modeling, number one.

DR MARK: Right, number one. I like to put that out there. Number two, part of it is exposure. As interesting as it sounds, the earlier the better. Now, hopefully we’re going to catch some folks early on with this. If you have a younger child, part of it is exposures. Children, as they get older, become meal-phobes. That’s a fancy word but “phobe” means hate and new and they don’t like change. They don’t like new things necessarily. One of the important things is exposure early on if you want to prevent picky eating or have somebody who seems like they’re going to turn into a picky eater, try to get them to be exposed to different tastes and different flavors. That’s part of the reason why some times kids who are breastfed, for instance, do better with new tastes, new flavors because they’re exposed to a whole bunch of things through mom’s breastmilk. So, part of this exposure--and there’s actually been studies that show basically for food to be accepted by a child, sometimes it takes somewhere between eight to eleven exposures. Think about yourself. If something changes in your routine, the first time you do it or you taste it and it’s kind of like “Oh, that’s new. I don’t know if I like that, it’s different. I never had anything like that.” Then, after a time or two, I’ve had that before, it’s, “Okay. It’s not bad. I’m not going to drop dead from eating it.” Then, after you get towards that eighth or eleventh time, I’ve had this before, “I like this.” So, part of it is exposure and, again, early on. The more exposures early on, the better. If you have somebody’s that…

MELANIE: Exposure is mainly the key, but what if your child looks at it, turns their nose down? I mean, I’ve seen so many kids that just look at it, they make this total disgusted face and they won’t even try it? Do you threaten? Cajole? What if it’s somebody else’s kid and they’re sitting at your dinner table?

DR MARK: You used the right word there and that’s” try”. Sometimes, you have to literally make that exposure and that’s why exposure is so important. Remember, eight to eleven exposures to be accepted. So, one of the key things sometimes you just need to get them to taste it and again, modeling. Say “Ok. I’m going to take a little bit of this. It’s good. All I want you to do is try it, and you don’t have to eat anymore. Just try it. Take a bite. Okay. We’re done.”
Melanine Cole: Do they have to swallow the bite?

DR MARK: Some people would argue with that. Literally, if you get it in their mouth the first time, I think that’s most important thing.

MELANIE: I like them to swallow the bite. I say, “Just swallow it. It’s not going to kill you.”

DR MARK: Once you have it in the mouth-

MELANIE: You’ve got it in your mouth. It’s disgusting to spit it out, so just swallow it. So, we want to role model. We’re going to get you to try.

DR MARK: A lot of times, you take the taste first, “Hey I like this.” Then, of course, you may have to make sure you don’t do the scrunch face look. But, literally, the first time it’s just literally get them to taste it. And if you think about that, like I talk about exposure, just to taste. The next time that food comes across the palette, it’s like “Okay. You’ve already had this once and you tried and you didn’t turn green or fall over. It’s okay and take a bite this time.”

MELANIE: Dr. Corkins, do you like it when some nutritionists talk about hiding those healthy foods in for those picky eaters?

DR MARK: I have no trouble with the macaroni and cheese containing cauliflower. I have no problems with that and we’re working with two different goals here. The goals of hiding it is to get them the nutrition, to make sure they have a well-rounded diet. If you have to hide it to do that, sometimes subterfuge is okay. In the long run, however, you eventually want them to eat it or you’re going to be sneaking your whole life. No, you don’t want to be sneaking around your entire life, what you really want, honestly, is you want them to eat it. Hey, if you’re trying to work on a picky eater and you want to get some vegetables in their diet, hey, you blenderize some things and you mix it in and that’s fine for a little while. That’s to get their diet in a well-rounded fashion. In the long run, though, you literally, your investment of effort is much better to work on getting them to eat it in the long run.

MELANIE: It sure is because in the long run you want them to be able to go anywhere in the world and eat anything without having plain butter noodles or chicken nuggets or something along those lines. So the exposure, the role modeling, getting them to try it, discussing it with them. So, what else can you do to get them to not be a picky eater in general, to just be more open, whether they’re at somebody else’s house? We only have about a minute left.

DR MARK: Well, I like...Actually, it’s interesting because kids tend to be meal-phobes but if you get in them into a mode, though, it’s like “Hey. Here’s something new. I’ve never tried this before.” Again, part of this is modeling. “Hey, we’re going to this party and here’s this fruit that we’ve never had before. I’m going to try it. Eh, it’s ok. You want to try it? Here try it.” And I think that in the long run because we are going to be exposed to new things, in today’s environment in our culture, we have lots of different foods and we have lots of different cultures that are in our country. We’re a melting pot. We’ve always been a melting pot and sooner or later in school they’re going to have a classmate who brings something in who’s from a different culture, and we try to present that as “This is cool. You may not like it, but you should try it.” It’s, again, the idea of it’s actually kind of cool to try something new.

MELANIE: I think it is.

DR MARK: It is. Again, that’s an attitude. It’s both, again, train them to try. You don’t have to like it the first time you see it, just try it. That’s all we’re asking is try.

MELANIE: This is great advice, is just to try. You must role model. You must try certain foods a bunch of times before your child is really, really ready to say “No, that is a food that I don’t think at any point in my life I’m going to start to like.” But remember to explain to your child their taste buds are going to change throughout the years and so keep trying those wonderful foods. Ask your child for help in the kitchen preparing the foods because then maybe they not going to be so afraid of something like a beet if they help roast it, they help peel it, so their hands get a little red, but maybe they might just love it.

You’re listening to Healthy Children, right here on RadioMD. This is Melanie Cole, stay well.